RMT Matters · 2015-12-21 · RMT Registered Massage Therapists’ Association of British Columbia...

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Registered Massage Therapists’Association of British Columbia

VOLUME 8 ISSUE 3

Matters

The History of Sports Massage

RMT MATTERS GETS MORE THAN JUST A FACE-LIFTThe redesigned RMT Matters offers in-depth content with dedicated sections for Real World Stories, Regional Content, Research and more!

RMTs TO THE ATHLETES

Understanding the relationship between patient and practitioner

3D MEDICAL ILLUSTRATIONS

Learn how to use this interactive tool on RMTBC.ca for your practice

FASCIA RESEARCH CONGRESS

First hand experiences sharedby a Congress Participant

Featured Articles

CONTENTS

REGIONAL

RESEARCH & LEGAL

2 PROCLAMATIONRMT Week as proclaimed by the BC Government!

4 RMTBC UP CLOSEMeet the people in the office at the RMTBC

26 FASCIA RESEARCH CONGRESS SPORTS MOVEMENTUnderstand how fascia relates to sports and movement.

28 3D ANATOMY ILLUSTRATIONSAn RMTBC Member Benefit: Get a closer look at the human anatomy and how you can share it with your patients through Primal Images.™

29 LATEST IN SPORT CLINICALLY RELATED RESEARCHA small sample of the Current Awareness Tool being developed by RMTBC.

9 RMTs TO THE ATHLETESEver think of focusing your practice towards athletes? Find out what these RMTs have to say about the experience.

18 THE HISTORY OF SPORTS MASSAGEDid you know MT helped the Romans, Egyptians, Chinese & more cultures in sports? You will after reading this article.

22 FROM START TO FINISHOur colleages from RMTAO lend us an article from Dr. Anthony Lombardi which highlights steps to consider when treating patients.

11 MT2016The next RMTBC conference for all health care practitioners.

5 FROM THE DESKHow do we as professionals stay ahead of patient demands?

RMTBC

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RMTBC UP CLOSE

Professional Practice Group (PPGs)RMTBC is providing an opportunity for members who are interested in specific areas of clinical practice. Through research supported by the association, PPGs will build on that collective knowledge base and grow a body of best practice to be shared within the profes-sion. Currently we have PPGs for First Nations, Pain, Sport, and Women’s Health and now Seniors. Mem-bers who are interested in a specific area of practice can join one of these PPG’s.

Continuing Education Credits (CECs)Did you know that RMTBC advertises and sponsors a large range of continuing education courses? These courses offer :

• higher educational standards• extensive research studies proving the efficacy of

massage therapy

Member Affinity ProgramVarious offers are made available to members from local & national companies. Find out more on RMTBC.ca members’ section.

FIND AN RMTOnly members of the association are listed on the public and members RMTBC.ca website.

RMTBC members receive discounts on all Professional Education Series courses as well as advertising through RMTBC mediums.

Massage Therapy Awareness WeekRegistered Massage Therapy Awareness Week was proclaimed by the BC Government from October 19th – 25th 2015. RMTBC requested this proclamation to bring more awareness to our profession and members. We will look to build on the week annually.

Member BenefitsJust to name a few:• Practice Development, including sample contracts,

clinical medical forms, research, Practice Assistance, Mentorship and PPGs

• Insurance, including malpractice, travel and life insurance; Member Assistance Program (MAP) with Ceridean’s LifeWorks Program; and Legal Guard® Information Service by Novex Insurance

• Tax and Legal Advice• Community Health Fair Package• Referral and Advertising Services• Case Repository (CaseRe3)

RMTBC Team (From left to right)

Top row: Kristina Oldenburg, Brenda

Locke, Nancy Bohonoski, Abbas Virji, Scantone Jones,

Dave DeWitt, Dereck Kankam.

Seated: Kirk O’Bee, Alison Chernoff,

Bodhi Haraldsson.

Not in picture:Harriet Hall

Membership Renewal Available Now: www.rmtbc.ca/renew


RMTBC

FROM THE DESKhen we look at ourselves professionally, we know we are

a regulated profession. We know we have to meet minimum educational and competency requirements to enter the practice; and then renew our knowledge through annual continuing education. This is all for a pretty obvious reason – we have a primary role to play in the health and improved health of our patients, so our competence and skill are paramount. It’s supported by the fact that 82% of respondents in the RMTBC survey dated 2015 reported that they see themselves as healthcare professionals not as technicians. I’ve written about this before. We are well-trained, well-educated professionals who provide treatment to our patients to improve their health outcomes, and we do this all in our patients’ best interests. Every RMT shall act in the best interests of the patient. It’s the law. You can only provide treatment if you reasonably believe it will help your patient and then, you can only provide massage therapy treatments that fall within the scope of practice. So what happens when our patients become more knowledgeable about their own health; more demanding of treatment modalities, and more vocal and active in achieving outcomes? The RMTBC learned some time ago that our patients today have greater knowledge of their own health issues and the level and type of care they wish to receive. But more than that, patients have more complex realities, competing health issues, conflicting lifestyle choices, and new synergistic healthcare concerns caused by more intricate and concurrent health issues. Add to this new reality the overabundance of information available on the Internet: some correct, some incorrect, and some downright misleading.

So how are we, as professionals – as the experts in massage therapy – to not only keep up with patients’ health issues and demands, but to stay ahead of them?

How do we maintain the professional advantage?

In my view, there are two answers. First, I think we need to strengthen our entry to practice requirements, and make our interjurisdictional competency document a living, breathing document, that grows and flexes and changes with the times and with demonstrated need. That document, in my view, needs to have far more practitioner input than it does currently. It is the practitioners who are most familiar with the changing needs of patients and with how to respond to those needs with current treatment modalities. We know what education might be missing, and we can suggest education to meet future needs. Second, we need to internalize the concept of lifelong learning. It isn’t a process to follow to gain the required number of credits to tick off a box with our regulatory body. Continuing relevant education makes us better practitioners. Through lifelong learning, we can stay ahead of the curve, learn new treatment techniques, see the trends, and then think critically to address emerging issues. That way, we are better equipped to competently address the questions our patients have. Our members crave this. In the summer 2015 survey, it came as no surprise that more than 70% of respondents were interested in monthly one-hour webinars to improve their skills and knowledge. More than a third of respondents did not feel current resources adequately support continuing competence and professional development. And a whopping 82% said we need to develop new competencies that address such issues as critical decision-making. This is the new RMT, a healthcare professional responsible for addressing current issues in healthcare in our patients, a healthcare professional who continues as a lifelong learner, advancing professional competencies. RMTs demand this; our patients deserve no less. RMT

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RMT Registered Massage Therapists’ Association of British Columbia

www.rmtbc.ca

EditingScantone Jones, Jessica ter Wolbeek, Brenda Locke, Anne Horng and Mike Reoch

Artistic DirectionRachelle Paradis, Abbas Virji, Dave DeWitt

[email protected]

Content ContributorsAaron Ashe, Alison Coolican, Jamie Johnston, Bodhi Haraldsson, Hana Holland, Anne Horng, Joey Lattanzio, Dr. Anthony Lombardi, Michael Reoch, Corey Van’t Haaff, Amanda Wanner

Registered Massage Therapists’ Association of British Columbia

Suite 180, Airport Square Tel: 604-873-44671200 West 73rd Avenue Fax: 604-873-6211 Vancouver, BC V6P 6G5 www.rmtbc.ca [email protected]

For complete contact info, please see page 31

RMT Matters is published three times a year for Registered Massage Therapists (RMTs). This publication intends to provide a voice for RMTs and to act as a source for the latest research plus a vehicle for the general population to understand and respect the valuable work of RMTs. Funding is provided by RMTBC and through advertising revenue.


M a t t e r s

© 2015 RMTBC. No part of this publication may be duplicated or reproduced in any manner without the prior written permission of the RMTBC. All efforts have been made to ensure the accuracy of information in this publication; however, the RMTBC accepts no responsibility for errors or omissions.

M a n u a l T h e r a p y C o n f e r e n c e An Interd isc ip l inary Approach to the Science and Pract ice

R M T B C C o n f e r e n c e , A p r i l 1 6 - 1 8 , 2 0 1 6Anvil Centre, New Westminster, BC MT2016.com

RMTBC

Professional Education Series

April 16 - 18, 2016

In April 2012 RMTBC hosted the sold out 3rd International Fascial Research Congress here in Vancouver. In March 2014 RMTBC held another successful conference, “Pain Management” with its partner PainBC. International pain experts presented the latest on the neurophysiology of pain, biopsychosocial issues and the use of manual and movement therapies to help patients with persistent pain effectively, safely and emphatically.

We are expecting a diverse audience of health care professionals mainly from the manual disciplines. Participants will increase their understanding of various therapies by learning the most recent developments in the field.

EMPHASIS ON EVIDENCE-BASED TECHNIQUES

SOUND SCIENCE WILL UNDERPIN THEORETICAL CONSTRUCTS

RMT MATTERS | VOL 8 ISSUE 3 - rmtbc.ca6

RMT MATTERS | VOL 8 ISSUE 3 - rmtbc.ca

Presentations will address the science and practice of manual therapy using safe, effective manipulative and movement therapies.

Keynote speakers include:

Eyal Lederman “A Process Approach in Manual Therapy: Beyond the Structural Model”

Sandy Hilton “Importance of Assessment and Treatment for Complex Pelvic Pain Disorders in Women and Men”

Walt Fritz “Research Can Change Your Approach to Assessment and Treatment and Assist your Evolution as a Health Care Professional”

Ravensara Travillian “Working with trauma and PTSD affected patients in the manual therapy clinical environment”

For more information: https://www.rmtbc.ca/mt_2016

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REGIONAL

RMTs to the Athletes

During my first 7 years of practice, I operated and managed 2 different clinics out of 2 different fitness facilities. These locales exposed me to a multitude of different athletes/sports and a realization of how massage therapy could help individuals achieve their goals. I also started to teach at the Vancouver College of Massage Therapy (formerly Utopia Academy) in 2006. In 2012, I started working with the Vancouver Whitecaps FC of the MLS.Aaron Ashe

I’m a Registered Massage Therapist from Vancouver, BC, who has been practicing for 5 years with an area of focus in sports for my entire career. I work and have worked with various professional athletes including athletes from the National Hockey League, Major League Soccer, National Basketball Association, and X-Games. I was one of the official massage therapists for the Vancouver Whitecaps for 2 seasons and am currently the massage therapist for the Canadian Women’s National Soccer team.

I’m a RMT working and living in Victoria, BC, who enjoys running a collaborative blog for massage therapists at www.themtdc.com. I also volunteer as a firefighter, as well as a first aid and first responder instructor. Previously I was a clinical supervisor at WCCMT Victoria. I graduated from WCCMT in December of 2010, but had started volunteering with the Victoria Grizzlies hockey club in 2009 for the RBC cup and have remained with the team since. Last year I was privileged enough to be the team’s head trainer, while also supervising Athletic Therapy students and getting some students from WCCMT involved. This year I have also had the opportunity to work with the Canadian Men’s Rugby team.

Hana Holland

James Johnston


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What sports teams have you been involved with to date?

AA: I have worked with a multitude of individual sport athletes both at the amateur and elite level – endurance sports, mountain bikers, road cyclists, ski and snowboard racers, hockey players (amateur - NHL), basketball (amateur - NBA), football (amateur - CFL), baseball/softball (college), martial artists and more. Currently I am part of the massage therapy team for the Vancouver Whitecaps FC of the MLS.

HH: I have worked for the Canadian National Slopestyle Snowboard Team, Vancouver Whitecaps, BC Lions, UBC Track and Field team, and am currently working for the Canadian Women’s National Soccer team.

JJ: I’ve been with the Victoria Grizzlies; this is my seventh season with the team. I have also been doing a little bit of work with the Rugby Canada Men’s team this year.

What has been the most surprising role you have had to play as a sports MT for an athlete or team?

AA: I was asked to operate the video camera from way up in the rafters, for a pre-season game, for video analysis.

HH: I have to be ready to wear many hats while travelling with a team - other than being an RMT, I have been incorporated in the drills, filmed training or prepared post-training nutrition for the athletes.

JJ: I think just being the one to communicate with the team GM and coaches regarding player injuries and not being able to put someone back on the ice. Also being the team medical director and managing players going to team doctors/chiros and having to be in constant communication to organize what’s happening.

The AthletesHave you ever been star struck by an athlete? If so, when?

AA: I admire any athlete who devotes his or her life to excelling at their craft. Working with a team you cannot afford to be star struck as that can interfere with both your job and theirs.

HH: Most of the time no, but I did get a little start struck once. I grew up playing basketball. I got to treat one of my childhood heroes. All in all the athletes are normal people doing extraordinary things.

JJ: I’ve met a number of NHL players who have been around the team, but haven’t really been star struck, although was pretty nervous getting the courage up to talk to Bob Nicholson at a game.

About the RMT Why did you decide to become an RMT in the first place?

AA: I was an active individual and I decided I wanted a job that would allow me to promote an active lifestyle – some sort of rehabilitation therapy. At the time, all I was familiar with was either physiotherapy or chiropractic as options. I was nearing the completion of my degree and actually working towards getting into the physiotherapy program when I ran into a couple of old friends, who had just completed the massage therapy program at WCCMT. After some thorough investigation into just what the program entailed, its employment opportunities, and what the curriculum included, I decided that massage therapy was what I wanted to do.

HH: I knew I wanted to be in Sport Medicine to some degree and it was just a matter of how to do it. I came across massage therapy as an athlete and found it beneficial. I really liked the hands-on approach that RMTs have with treating athletes.

JJ: I was an industrial First Aid attendant at a sawmill and really enjoyed working on people. When the mill shut down I decided to go back to school, so I did some aptitude testing to see what I could do and massage therapy came up as a possibility. Once I started checking into it and realized I could possibly work with athletes, I signed up for courses that September.

RMTs to the Athletes, cont’d

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RMTs to the Athletes cont’d

Do the athletes often play injured to their own detriment?

AA: If the coaching staff and/or medical team are aware of an injury that is too acute for a player’s own good, the athlete will not play.

HH: At the elite level they do so at the competition stage, not so much in the training stage as it is not worth it. Even at that competition level they still wouldn’t risk their lives or careers.

JJ: They definitely try to, but are usually pretty good about taking advice from the trainers. They are always super motivated to get back on the ice and would be willing to play when they shouldn’t; so it’s our job to reign them in.

Do your patients do the exercises that you prescribe?

AA: Usually that is the case. Athletes tend to buy-in to what they are told, more so than the average individual. Most realize that you are giving them these exercises to help them return to play, or to keep playing and this is their career. Professional athletes usually do everything that is asked of them and more.

HH: Yes for the most part; almost always. We have an integrated approach with other medical practitioner teams. We make sure we convey the same message to the athletes and that the athletes do everything they can to stay healthy. Many times we have to make sure they are not doing too much of the prescribed exercises.

JJ: Yes, these kids are all trying to get scholarships or get drafted, so they’re very motivated to do whatever they can to get back in the game.

Have you ever become upset or frustrated with an athlete?

AA: It can be a challenge at times to get some athletes to buy-in to doing their exercises or getting regular treatment. I do my best to maintain a professional attitude when problems arise and reword or re-explain my rationale so there is greater compliance.

HH: Not that I can recall.

JJ: Yes, but things usually get sorted out pretty quickly

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EducationWhat were the courses or practicum during your initial diploma education that influenced or prepared you to work with athletes?

AA: I suppose it was sports outreaches such as working with varsity athletes at UBC that gave me the bug.

HH: I went into massage therapy school knowing that Sport Medicine was the direction that I wanted to go. The Sports Massage course in school was very basic but I did approach every other class with the mindset that I would be using it in sports in some way. I took it upon myself to volunteer for as many sporting events as I could during school and really took advantage of our practicum with the UVic varsity athletes.

JJ: We had a sport massage class that was taught by a local RMT who had been to the Olympics with the Canadian Dive team, so it was good to hear her experience and learn from her.

What gaps do you think there are in the diploma program that if filled would make working with athletes more achievable for RMTs?

AA: I think if there were more sports science courses – such as sport mechanics, or a more in-depth look at sport injury causation/prevention/ rehabilitation; perhaps including certified strength and conditioning specialization as part of curriculum. The development of a mentorship programme would provide great opportunities for therapists seeking employment in the athletic world. Research skills – particularly in searching for, reading, and understanding research papers/sports medicine journals – finding evidence-based/best practice. These are particularly useful skills when collaborating with other health care practitioners.

HH: I think it would be great if there was an additional Sport Diploma program offered at school. The Canadian Sport Massage Therapist Association offers a certification program already which is nationally recognized. If this became an additional option in the diploma program for those who wanted to focus in sports, I think it would give students an opportunity to move forward in their career with one foot already in the world of Sport Medicine.

JJ: First Responder (and I’m not just saying this as a First Responder/First Aid instructor). I have put far more hours in at games as a First Responder than I have as a RMT. You have to be ready at every facet of the game to provide advanced care if someone gets hurt. Having First Responder certification is the best way to prepare. Having that certification is one of the things that helped me get in with the hockey team.

What post grad professional ed courses have you taken that assisted with your work?

AA: Fascial Movement Taping, Somatic Explorations cadaver lab with my colleagues (Chiro, Sports MD, physio, and MT), Mark Finch’s fascia workshop on the spine, Susan Chapelle’s course on the shoulder girdle.

HH: The courses that I have found most useful so far for working with athletes are the Advanced Sport Massage Therapy Course and Sport First Responder. They gave me a solid foundation and I find that I always go back to this in one way or another. I also do a lot of reading whether it is Sport Medicine Journals or textbooks. There is a great International Sport Massage Diploma course which includes texts in Sport Psychology, Sport Physiology and Sport Injuries that I refer to and have found to be a great addition to my practice with the team.


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The Education cont’d

JJ: Graston technique, one of Joe Musculino’s courses for joint mobilization etc., Reconciling Biomechanics With Pain Science from Greg Lehman and I recently did the Precision Nutrition “Essentials of Sport and Exercise Nutrition” to get a better understanding of the nutrition side of things.

What post grad professional ed courses would you like to see offered in the future?

AA: Some sport-science related coursework. For example there is an interesting course offered by the IOC (International Olympic Committee) – a diploma in Sports Physical Therapies – currently offered only to AT’s and PT’s. I’d definitely like to see more orthopaedic-type courses offered – specifically related to sports.

HH: I’d love to see acupuncture included. That is really the only thing I’d like to see offered which isn’t out there already. I’ve seen it be of such benefit. Sometimes I realize that is going to be the best course of action. Sometimes the athletes have to wait to see another practitioner to have it done. I think it would be more efficient if we were allowed to do it.

JJ: More focus into exercise and rehab courses.

Do you have areas of study that you have yet to explore?

AA: I am always looking to expand my repertoire. Getting my Certified Strength and Conditioning Specialization is a priority.

I have also been perusing different Master’s Degrees in the sports science/rehab area.

HH: I haven’t explored too much craniofacial therapy but I think I would like to know more since soccer is where I spend my time. I think it would be beneficial in dealing with head and neck pain as the athletes are often heading the ball.

JJ: Personal training and exercise. I know that UBC offers Masters in Rehab; I would like to look into that. I really think we need to expand our scope of practice and include nutrition as well as being able to do ultrasound, shockwave therapy, etc like RMT’s are able to in Ontario.

Looking back on your training what do you think has been the most beneficial in preparing you for your role as a sports RMT to the Athletes?

AA: Having the right attitude to work with other health care practitioners and a willingness to learn. As well as learning about biomechanics, injury recovery, and rehabilitative practices.

HH: I would say the CSMTA (Canadian Sports Massage Therapy Association) for sure. Being involved with that has given me guidelines about what courses would be beneficial and has helped me to broaden my network and gave me an opportunity to volunteer and build up my resume so I could work in a paid position like I am now.

JJ: First Responder, I use that more than anything else.

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The Specifics

What is the worst injury you have had to treat? How did you treat it?

AA: A recurrent dislocating shoulder/labral tear. I had a competitive crossfit athlete – former university track competitor – who was preparing for competition in the national crossfit regionals and had recurrent shoulder pain/instability. Assessment indicated there was a labral tear and I advised a visit to a doctor. A sports medicine MD visit followed by MRI revealed a slap lesion – surgery was scheduled. This athlete was determined to compete in the regional competitions for crossfit. When performing any overhead powerlifting the shoulder was very unstable and subluxing at times. The athlete wanted to work through the pain, against advice and was getting fascial taping (by a physio) prior to competitions/practices. The athlete came to see me to manage compensatory symptoms.

HH: I haven’t had to treat a lot of scary stuff as a massage therapist. I would say post operative, fractures, someone dealing with an ACL coming back from surgery. I have worked with others to make the athletes ready to get back to play after injury. Myofascial release is a technique I often use to deal with these circumstances.

JJ: Broken Clavicle, lacerated tibialis anterior and broken hip (ilium) on one person. Concussions are always a big one. In each case it was First Responder knowledge that helped me deal with it and get kids sent off to hospital for more advanced medical care.

What are the most common injuries that you treat?

AA: ACL reconstruction rehabilitation, SLAP lesion repairs, muscle strains.

HH: I’ve seen things from head to toe. I think the thing I deal with the most is muscle fatigue, tightness, and soreness. Athletes come to me mostly to help with their recovery and mobility.

JJ: Working in hockey, there are always lots of groin pulls, stiff backs, neck injuries and then just various injuries that happen throughout a game that need to be dealt with. Hard to pin down just one thing, but I would say with hockey players there are lots of low back, glute, and adductor injuries every year.

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The Specifics cont’d REGIONAL

How would you usually treat such an injury?

AA: In our model of integration, typically MT is used to increase tissue mobility and facilitate the PT or chiro work. Allowing their treatments to focus more on rehabilitation than manual treatment.

HH: I assess and determine the areas that need to be treated. The techniques I choose to use are determined by what I see in the assessment but also from knowing how the athlete responds to a specific kind of technique. The advantage to working with a team is that you have consistent feedback from the individual and can see results of treatment in their performance on a daily basis. From that information I can build very specific treatment plans so I don’t necessarily treat the same injury on different players in the same way.

JJ: We have always been fortunate to have the team chiro, myself and at minimum a student AT to work with, so it’s usually a collaborative effort. I did some research a couple years ago on groin pulls in hockey players and it pointed to the cause usually being tight glutes and weak adductors due to the motion/ technique of skating. So whenever the boys present with that I usually work through the glutes before addressing the adductors and have had pretty good success with that approach.

Looking back on your career, what has been the most challenging issue you had to deal with?

AA: I think challenging the typical model of injury intervention – i.e. primary care of sports injuries referred first to PT. Why can’t MT be that first care provider? It is still a challenge getting MDs/Sports Medicine to refer to MT as primary care.

HH: I’d have to say that I made a lot of sacrifices and I think there were times I over-extended myself with volunteer work. I was going to do everything I could to get myself where I needed to be. I found myself struggling financially at one time. I had a very clear goal so I kept working at it and I knew it would pay off. Some of the people I graduated with were already working and paid off their student loans and here I was volunteering and still paying off the loans. There might have been better ways of going about it but that’s the way I went about it. Probably not what people want to hear but sometimes you have to be broke first.

JJ: When uncertified people try to get involved. Without going into detail, there have been times when an athlete was signed off to return to play by someone who had no business signing them off. There could have been major ramifications if the player was hurt, so it’s always tough to have to deal with that sort of thing.

What advice would you give to students and/or other MTs who are interested in sports massage with teams?

AA: Have strong orthopaedic assessment skills. Learn evidence-based practice techniques. Get involved with Canadian Sports Massage Therapy Association (CSMTA)/Sports PPG (RMTBC). Volunteer at local sporting events, or with amateur teams (providing treatment). Listen. Collaborate. The primary therapist (AT or PT) of a team is typically the lead. Often the role of a MT is not to assess, but to treat as directed and help facilitate the athlete’s recovery and regeneration. Rehabilitation and specific injury treatment is directed by the lead. (Sometimes the primary therapist is a MT!) Be humble, enthusiastic, have fun and never stop learning.

HH: I would say getting involved with the CSMTA for sure. It gave me great guidelines on what courses to take and opened me up to a network of mentors and like-minded individuals.

JJ: You had better love what you’re doing because you’re not going to make much (if any) money on it (at least this has been my experience). However I still get excited to show up to the rink and work with the kids. If you really love a sport just start reaching out and volunteering. Try to make yourself more marketable by having something more than just massage to offer. Get that First Responder ticket, a personal training cert or something else that adds more to the table. My First Responder background was one of the things that got me in the door because the AT knew that he would have an extra set of hands in an emergency. I know most pro teams are now looking for people with several letters behind their name because they want as much as possible from each person. But I really think the biggest thing is to just start reaching out and volunteering to start, just get your foot in the door and then start networking and making more connections. Build relationships within the sport community and go from there.



History of Sports Massage

I like a deep sports massage – a casual beating up. I try to get them whenever I can, usually more if I’m getting in shape for a role.

Chris Pine, actor, known for his role as Captain James T. Kirk on the 2009 remake of Star Trek.

Chris Pine might know a thing or two about Vulcans and may be intimately familiar with the trouble with Tribbles, but he’s slightly off-mark about sports massage. Far from a casual beating up, sports massage is correctly defined as the application of specific and treatment-oriented massage techniques to an athlete (not an actor, sorry Chris) with the purpose of enhancing the athlete’s preparation for, or recovery from, the physical demands of training or competition. It’s applied pre-event, inter-event, post-event, and restoratively, often on-site at the sports event.

Its history is less clear. In his book The Art of Massage, written in 1895, J. H. Kellogg, MD, writes about the history of massage in general and mentions that massage was used by the Chinese thousands of years earlier.

An ancient Chinese book, The Cong-Fou of the Tao-Tse, was the foundation for modern massage and manual Swedish massage, according to Kellogg.

He also wrote of the ancient Greeks and Romans employing massage in connection with their famous baths.

Hippocrates, the renowned Greek physician, made extensive use of this mode of treatment, designating it anatripis. Hippocrates learned massage, as well as gymnastics, from his teacher Herodicus, the founder of medical gymnastics.

Asclepiades, another eminent Greek physician, held the practice of this art in such esteem that he abandoned the use of medicines of all sorts, relying exclusively upon massage, which he claimed effects a cure by restoring to the nutritive fluids their natural, free movement.

Ancient Romans were treated to a massage before and after Olympic events, and knowledge of massage led to the Chinese creating the first schools of massage in 100 AD.

Herodicus

Asclepiades

It was Claudius Galen, however, often referred to as the greatest physician of his time, born in 131 AD, who seems to be credited mostly for using massage with sport. He studied medicine in Egypt and, at the age of 28, became surgeon to a school of gladiators.

Galen introduced clinical observation: examining a patient very thoroughly and noting their symptoms. He also believed that disease was the result of an imbalance between blood, phlegm, yellow bile, and blood bile. He treated people based on his theory of opposites: treating people who were weak by giving them hard physical exercises to do to build up their muscles.

Galen apparently prescribed massage for gladiators both before and after exercising.

Other sources reference the Sandwich Islanders who, from ancient times, employed massage called lomi-lomi. Lomi-lomi was used on exhausted swimmers who were still in the water, supporting them until strength was re-energized by the manipulations.

J. H. Kellogg, MD


In 1812, Swedish fencing master and gymnast Pehr Henrik Ling combined the strokes of what we know as Swedish massage with remedial exercises, calling his technique kinesiotherapy. Most sources agree that by the 1900s, sports massage was being used.

The Finnish School of Massage was the first to officially lay out sports massage methods in 1900, though other sources attribute the techniques and theories of sports massage to Johann Mezger or Pehr Ling.

It was in 1924, however, that sports massage gained much credibility. The Flying Finn, runner Paavo Nurmi, won five gold medals at the Olympic Games in Paris including two different wins on the same day, separated by only one 30-minute gap in competition. Nurmi specifically credited his special massage as an important part of his training program.

During the half-dozen years after Nurmiís spectacular performance in Paris, Dr. I.M. Sarkisov-Sirasini formulated basic concepts for Russian Sports Massage and began teaching it at the Central Institute of Physical Therapy in Moscow. It has been reported that Soviet teams were the first teams to have a sports massage therapist travel with their athletes and to work on them on a regular and ongoing basis.

In the mid-1950s, Jack Meagher, (a pioneer in the massage therapy field, Jack was the massage therapist for two United States Equestrian Teams as well as for National Football League athletes) coined the term sportsmassage.

The use of his techniques of specific soft tissue applications based on anatomy, physiology, and muscular kinetics, became known as the Meagher Method of Sportsmassage. In 1980, his book Sportsmassage introduced the concepts of sportsmassage to massage therapists and athletes.

In the 1972 Olympic Games in Munich, Finnish track and field athlete Lasse Viren credited receiving deep friction massages for winning both the 5,000-metre and 10,000-metre runs. (He also won the

Claudius Galen

Pehr Henrik Ling

Johann Mezger

Paavo Nurmi

Dr. I.M. Sarkisov-Sirasini

Jack Meagher

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same two races at the 1976 Olympics in Montreal.)

The 1984 Summer Olympics in Los Angeles was the first time that massage therapy was televised as it was being performed on the athletes. In the 1996 Olympics in Atlanta, massage therapy was offered as a core medical service to the US Olympic Team.

In Canada, sports massage therapists work with athletes from almost every sport, provide services to teams competing at the Olympics and Paralympics, and assist active individuals and weekend warriors with getting the highest level of performance from their individual sport.

Written by Cory Van’t Haaff

Lasse Virén

SPORTS MASSAGE TIMELINE 500BC – Greek Hippocrates Herodicus – Founder of Medical Gymnastics

100AD – First school of massage in China

130AD – Galen in Egypt was the first to massage exercising gladiators

1700 – Sandwich Islanders employed massage called Lomi-Lomi on swimmers while in water

1812 – Swedish Pehr Henrik Ling creator of Kinesiotherapy

1900 – The Finnish School of Massage - 1st official school of Sports Massage

1924 – Winner Paavo Nurmi of Olympic Games in Paris acknowledged massage as important part of his training program

1930 – Dr. I.M. Sarkisov - Sirasini formulated & taught Sports Massage to the Soviets who were the 1st to have therapists travel with athletes

1950 – Jack Meagher coined the term Sportsmassage

1972 – Lasse Virén credited deep friction massages for winning 5,000 & 10,000 metres at the Olympic Games in Munich, and in Montreal

1980 – Jack Meagher introduced the concept of Sportsmassage through a book Sportsmassage

1984 – Los Angeles - first time massage therapy was televised while being performed on athletes

1996 – Atlanta offered sports massage as a core medical service to US Olympic Teams

Sports Massage Time Line

From Start to FinishEffects of Overtraining in Endurance Athletes

Functional Assessment and Treatment

Whether running a marathon, engaging in circuit training, or preparing for a fitness competition – during the training period – serious athletes are constantly stimulating the body to release endorphins which counter the impact of forces being absorbed by the muscular system. These endorphins do the wonderful work of improving the athlete’s mood to give a feeling of euphoria during exercises and practice sessions. The high continues through the training and peaks on the days close to the final competition. However, once you’ve met your goal and there is nothing more to keep you as stimulated, there is a sudden drop in the endorphin level, which causes isolated muscular weakness referred to as motor muscle inhibition 1.

Since the majority of athletes are recreational, rather than professional, they often run into the problem of overtraining. Interestingly, they do not feel the physical effects of overtraining until after the event that they have been training for is over. During the many months of preparation they are able to power through any pain, but once the race is run and they take a rest, everything falls apart mechanically.

There is actually a physiological reason for this which I try to explain in terms patients can understand. I use the analogy of a steel mill. In a steel mill there is a blast furnace that runs at temperatures above 800 degrees Celsius to cook the impurities from the steel during manufacturing.

By Dr. Anthony J. Lombardi

Content contributed by,RMTAO, Registered Massage Therapists’ Association of Ontario

These furnaces are built with mostly bricks and mortar and the furnace never completely shuts off because if they were to stop running they would simply fall apart due to the damage of the heat and overuse.

In a blast furnace, it’s the heat and the continuous use that keeps the furnace together and allows it to run – the same is true for endurance athletes and marathoners. Athletes who overtrain often have problems in the two weeks following the competition because while they are in training, physiologically the body is releasing endorphins and neurotransmitters, which prime the nervous system to ensure that the muscular system remains functional 14. Because athletes usually practise good nutrition habits they are able to feed their furnace so that it performs well on a daily basis.

Of course, like blast furnaces, one day things change and training ends - and it’s at this interval where injuries surface.

Assessing Overuse Injury in Athletes

Diagnostic Imaging

MRI and ultrasound imaging are common diagnostic tools used by medical doctors and therapists in determining tissue injury. However, several landmark studies have shown that tissue tears revealed on such imaging are very common in patients who are completely asymptomatic. A New England Journal of Medicine study by Jensen et al revealed that a MRI examination of the lumbar spine, showed many people without back pain have disk bulges or protrusions.2 Given the high prevalence of these findings and of back pain

RMT MATTERS | VOL 8 ISSUE 3 - rmtbc.ca22

23

sufferers, the discovery of bulges or protrusions by MRI in people with low back pain may frequently be just coincidental.

Consequently, experts say the use of MRI, a popular and sensitive imaging method, often leads to unnecessary surgery.

Orthopedic Testing

Simpson et al concluded that over-reliance on a single orthopedic test is not appropriate and that there is a lack of research to support the accuracy of spinal orthopedic testing 3. Cadogan et al revealed that the reliability of results in orthopedic shoulder testing between different examiners is inconsistent4. Contant did a systematic review of 34 studies and concluded that the reliability and validity of these assessment procedures remain questionable 5.

Since there is a lack of a causal relationship between diagnostic imaging results, orthopedic testing, and symptoms, we must look further into what is happening on a musculoskeletal level when patients who over train are experiencing pain and dysfunction. To understand the mechanisms at play, we must concentrate on three terms: Functional Assessment, Motor Muscle Inhibition, and Neurogenic Inflammation.

What Is Motor Muscle Inhibition?

Muscle Motor inhibition (alpha-motor neuron muscle inhibition) is when the nerve that sends the impulse to contract a muscle becomes unable to function at its optimal capacity due to chemical or physical trauma 7. This results in a perceived weakness of that muscle which changes the biomechanics of the entire region. The primary cause of motor inhibition is a sufficient amount of neurogenic inflammation which is released by the sensory axon to inhibit the motor neuron 8.

What Is Neurogenic Inflammation?

Neurogenic inflammation is continuing inflammation in the musculoskeletal system generated by nerve impulses and the release of inflammatory substances from the sensory axon at the site of the original injury. These substances are typically but not limited to: Substance P (SP), Calcitonic Gene Related Peptide (CGRP), and Neurokinin-A (NKA)8 .

Prolonged inflammation and pain can lead to protective muscle spasm,accumulation of fibrous

tissue and muscle shortening. The fibrous tissue form palpable taut muscle bands and trigger points; such muscle dysfunction and spasm lead to compression of blood vessels, and decreased blood flow - creating nociception 9. In short, nociception is the nerve’s reaction to chemicals that irritate it. Neurogenic inflammation, which can be caused by injury or repetitive strain, is the chemical which can become irritating to the nerve that controls a specific muscle. This causes that muscle to become inhibited.

Chronic nociceptive stimuli results in cortical delay of the motor output and a reduced activity of the painful muscle which can prevent effective motor retraining 10.

Why Focus on Functional Assessment & Motor Inhibition?

Gribble concluded that muscle groups in the proximal girdle of the kinetic chain of movement were associated with strength deficits in distal joint injuries - so even ankle injuries can cause the gluteus muscles to stop working 11.

Why Must We Find and Correct These Motor Inhibitions?

lIngersoll in Rehab Management concluded: “Without removing or reducing muscle inhibition, rehabilitation may essentially begin after healing occurs. We might also reduce long-term consequences associated with motor inhibition, including susceptibility for further or other injury 12.”

Sedory et al, in the Journal of Athletic Training summarized: “Treatments that have been shown to reverse the effects of muscle inhibition should be used immediately before therapeutic exercise is performed in an effort to activate motor units that may have been previously inhibited 13.”

Target of Massage Therapy Treatments

Applying massage therapy to overtraining and motor muscle inhibition injuries is a fundamental treatment option when managing these conditions.

When dealing with these injuries it’s important not to forget to address the autonomic vascular system - target the muscles which house the nerves that control the arterial blood flow to the muscles in specific regions of the body.

For example, T1-T5 are the spinal levels of the RMT MATTERS | VOL 8 ISSUE 3 - rmtbc.ca

From Start to Finish cont’d...

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sympathetic preganglionic neurons that via the cervical sympathetic ganglia will end up innervating the arterial network of the head, neck, shoulder girdle, and upper extremity. Conversely, T10-L2 are the spinal levels of the sympathetic nervous system via the lumbar sympathetic chain that innervate the arterial network of the pelvis, low back, legs, and feet 14;

If there are abnormal signals occurring at those vertebral levels, it is believed thatthese abnormal signals will interfere with the normal “sensory-motor-visceral-vascular sympathetic integration” that should take place harmoniously at every spinal level. Once this happens, the following progressive undesirable effects can happen 14;

• motor inhibition of muscles supplied by those spinal levels

• abnormal proprioception on those muscles• motor inhibition on paravertebral muscles

supplied by those spinal levels• abnormal proprioception on those

paravertebral muscles

Therefore, it is advisable to make these paravertebral levels the targets of any

acupuncture interventions in order to normalize “sensory-motor-visceral-vascular sympathetic integration” at those levels, thus interrupting the negative effects that the abnormal neurological signals from this segments may be having on the peripheral tissues.

References

1. “EXSTORE Assessment & Treatment System For Chiropractors & Manual Therapists,” 2nd Edition, AJL Publishing 2012.

2. Jensen et al. (1994). N Engl J Med, 331,69-73 3. Simpson et al. (2006). Chiropr Osteopat, 14: 26 4. Cadogan et al. (2011). Manual Therapy, 16 (2), 131-135 5. Contant. (2003). The Efficacy Of Lumbar Spine Orthopedic Testing. 6. “Functional Assessment A Global Perspective” Canadian Chiropractor Magazine, Oct 1,

20147. Le Pera et al. (2001). Clin Neurophysiol, 112(9), 1633-1641 8. Baluk. (1997). J Investig Dermatol Symp Proc,2(1); 75-81 9. Devor. (1999). “Evaluation and Treatment of Chronic Pain.” Baltimore: Williams, & Wilkins. 10. Nijs et al. (2012). Clinical Journal of Pain, 28 (2),175-181 11. Gribble et al. (2005). Journal of Athletic Training, 40, S-28 12 .Ingersoll et al. (2003). A Joint Dilemma. Rehab Management, Jan/Feb 13. Sedory et al. (2005). Journal of Athletic Training, 42 (3), Jul-Sept 355-360 14. Dosch, Peter, “Neural Therapy” by Huneke and Huneke, 2006.

26

Tendons and Tendon Injuries

Most of the lecturers touched on this area of research in some way, whether it be the physiological structure and behaviour of tendons, how to train tendons to be stronger and more resilient, or ways to treat tendons that are injured.

Michael Kjaer, MD, head of the Institute of Sports Medicine, Bispebjerg Hospital in Copenhagen and Clinical Professor in Sports Medicine at University of Copenhagen, Denmark, presented his research1 which supports the idea that eccentric loading of a tendon and weight training are still the best choices for rehabilitation from tendon injury. His group studied 49 untrained males, ages 21-45, to observe whether weight training, recreational soccer, interval running or steady-state run sessions affected muscle output, muscle fibre adaptively and neuromuscular activity during maximal jumping. The weight training group showed elevated power

FASCIA RESEARCH CONGRESSSPORTS MOVEMENTFascia as it relates to Sports and Movement: A glimpse of what I learned at the 2015 Fascia Research Congress.

This year’s Fascia Research Congress in Washington, DC offered a bounty of new information from the micro to the macro level in the world of fascia. Sports and movement is an area where this information is highly applicable and I attended a number of lectures and a workshop that focused on this area. Here is a glimpse:

production and an improvement in neuromuscular activity as measured by quicker and more explosive turning and jumping strategies. Of note, the strength training exercises were squats, hack squats, lunges, incline leg press, isolated knee extension, hamstring curls and calf raises.

Antonio Stecco, MD, who specializes in Physics Medicine and Rehabilitation at the University of Padua, Italy showed some very detailed images of the Achilles tendon and paratendon. His current research in this area backs up the idea that we call tendon injuries “paratendinopathy ”.

This is because the paratendon, which is made of springy, bundled collagen and is highly innervated, is the structure that shows the most inflammation and thickening in tendon injuries.2


27

Training the Fascial Net for Better Performance

References:

Jakobsen, Sundstrup, Randers, Kjaer, Andersen, Krustup, Aagaard. 2012. The effect of strength training, recreational soccer and running exercise on stretch-shortening cycle muscle performance during

countermovement jumping. Human Movement Science. 31:970-986.

Stecco, Busoni, Stecco, Mattioli-Belmonte, Soldani, Condino, Ermolao, Zaccaria, Gesi, Brettler. 2015. Comparative ultrasonographic evaluation of the achilles tendon and paratendon in symptomatic and asymptomatic subjects: an imaging study. Abstracts and posters presented at the 4th International Fascia

Research Congress 2015.

Schleip, Muller. 2012. Training principles for fascial connective tissues: scientific foundation and suggested

practical applications. Hand Ther. 25(2):133-140.

Fisher, Zhao, Rico, Massicotte, Wade, Litvin, Bove, Popoff, Barbe. 2015. Increased CCN2, substance P and tissue fibrosis are associated with sensorimotor declines in a rat model of repetitive overuse injury. J.

Cell Commun Signal. Full text obtained from,

www.researchgate.netpublication271536838_Increased_CCN2_substance_P_and_tissue_fibrosis_are_associated_with_sensorimotor_declines_in_a_rat_modelof_repetitive_overuse_injury

One of the afternoon sessions that I attended featured an interesting explanation of Robert Schleip’s Fascial Fitness model. He is a researcher and clinician from the Division of Neurophysiology at Ulm University in Germany. His published work describes how focused training of the fascial network can be of great importance for athletes, dancers and other movement advocates. Fascial training stimulates fibroblasts to lay down more “youthful fibre architecture with a gazelle-like elastic storage capacity”3 and helps to tune the proprioceptive capabilities of the superficial fascial layers of the body. Essentially, the movements involve a preparatory counter movement with slight pre-tensioning into a long multidirectional plane, smooth slow movement through a particular range of motion (he calls it ninja-like), with soft mini-bounces at the lengthened stretch position. Tiny and specific local movements can be used to bring proprioceptive attention to neglected areas of the body where there may be “sensory-motor amnesia”.

Further, Geoffrey Bove, DC, PhD, provided evidence from his ultrasound studies that added to our growing base of research involving sliding between fascia and nerve interfaces.4 Fascia is a sensory organ and recent findings indicate that the superficial fascial layers are more densely populated with sensory nerve endings than deeper connective tissue. In sports and movement, attending to this tissue is important in order to improve proprioception, decrease DOMS, and help heal injury.From the micro to the macro, this area of research is growing and if anyone is interested in reading more, I would highly recommend purchasing the congress proceedings book that contains 37 research articles published since the congress in Vancouver (2012).

It can be found here: www.fasciacongress.org/2015/conference/dvd-recordings- and-books/

By Alison Coolican

RESEARCH



PRIMAL PICTURESAnatomical Images Online

Customize anatomical images from your online library!

Want to print images, labelled and angled exactly how you want them, to use for patient education? Or maybe you just want to refresh your own knowledge? Use the 3D Real-Time product in Primal Pictures!

Display fascia, veins, arteries, muscles and more, and rotate the images to display whatever you need. For example, this image of a shoulder shows muscle, vein, nerve and lymph systems. I hid some cartilage, the sternum, and the pectoralis, to put focus on the anatomical structures I wanted to display.

Read on to see how to access and tailor the images. You can also check out an online video demo on how to manipulate and download images.

How to Access this Application

• Log in to the RMTBC website, with your member username and password.

• Use Safari, Firefox, or Internet Explorer, for your

MacBook, PC laptop, or desktop. (3D Atlas works on iPad, but 3D Real-Time uses Flash, so it’s not available for mobile.)

• Go to the Library page, under Research. • Click Primal Pictures Premier Library Package, or

view the video overview linked below it.

• Click 3D Real-time. • Download the free Unity web player. It should

work right away, but that depends on your brows-er settings; you may need to adjust the security level and allow the Unity plugin.

• Select a category: Head and neck; Spine; Shoulder

and arm; Forearm, wrist and hand; etc.

• Customize the image and print.

Images on this page are copyright Primal Pictures.

Want more details about accessing the program?

• Select an anatomical region. I clicked Leg, ankle, and foot.

• The program displays an anterior view of that part of the skeletal system.

• The names of other systems will load at the bottom of the screen: ligaments, arteries, veins, nerves, muscles, lymph, and fascia. That’s where the fun starts!

• Some images also have “other”: for example, “other” for the Head and neck includes eyeballs.

• For this foot, I clicked

Ligaments, Arteries, and Veins, to add these to the picture.

• I then rotated the image by dragging it with my mouse.

• To see a wider-angle

view, click Controls on the bottom left of the screen, then zoom out.

• To hide or highlight part of an image, click on it, then click Hide, Show, Xray, Inspect, or Context on the bottom right of the screen.

• Use the tools on the top of the screen to label parts of the im-age, or save it. RMT

strategies for reducing symptoms of overreaching and reducing the risk of developing overtraining syndrome.

Basic recovery aids: What’s the evidence? Peterson, A. R et al (2015). Current Sports Medicine Reports, 14(3), 227–234.

This review discusses evidence for different exercise recovery methods, including compression, massage, calorie replacement, cold

therapy, and heat therapy. Findings indicate that different recovery aids might be beneficial to certain athletes in certain conditions. Massage, for example, may delay DOMS but diminish muscular strength in the short term.

A neuroscience approach to managing athletes with low back pain. Puentedura, E. J et al (2012). Physical Therapy in Sport, 13(3), 123–133.

This literature review on the neuroscience of managing lower back pain in athletes provides an overview of the neurobiology of pain and suggests clinicians should embrace a biopsychosocial approach to working with athletes. Recent evidence suggests that a biopsychosocial model that helps combat patients’ fears and anxieties around their pain through education, in addition to traditional manual therapy techniques, can help reduce

patients’ perception and attitudes about their pain. RMT

Want more synopses of recent research articles like this? RMTBC is developing a clinically related research Current Awareness Tool (CAT) database. Stay tuned for further announcements.


RESEARCHTHE LATEST IN SPORT CLINICALLY RELATEDRESEARCH: Current Awareness Tool (CAT)

Musculoskeletal physiotherapists’ use of psychological interventions: a systematic review of therapists’ perceptions and practice. Alexanders, J et al. Physiotherapy, 101(2) 2015

This review discusses six published papers on physiotherapists’ perceptions of psychological interventions. Many physiothera-pists receive little to no psychological training, yet commonly use techniques such as goal setting, positive self-talk, effective com-munication, and variation in rehabilitation exercises as a means to reduce stress and anxiety in injured patients. Utilizing psychological interventions in rehabilitation could help maximize the potential of individual patients; however, more research is needed on specific techniques and interventions

Stem cells, angiogenesis and muscle healing: a potential role in massage therapies? Best, T. M, et al (2013). British Journal of Sports Medicine, 47(9).

This review paper discusses the evidence for conservative treatment of skeletal muscle injuries sustained by athletes, including gene therapy, exercise, neuromuscular electrical stimulation, and massage therapy. Several recent articles have found that massage therapy applied after eccentric loading can reduce symptoms of muscle soreness and promote recovery; however, more research with standardized magnitude, duration, and frequency of MT is needed to make firm conclusions. Potential biological mechanisms for massage therapy efficacy are also discussed.

Spinal interventions: The role in the athlete. Jagadish, A, et al (2013). Operative Techniques in Sports Medicine, 21(3).

This review paper discusses conservative strategies for managing lower back pain in athletes. Strategies discussed include cold vs. heat, massage, exercise, ultrasound, traction, bracing / lumbar supports, chiropractic manipulation, injections, acupuncture, and return to play guidelines.

Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Meeusen, R et al (2013). Medicine and Science in Sports and Exercise, 45(1), 186–205.This joint statement provides an overview of overreaching vs. overtraining syndrome in athletes, including differential diagnosis and considerations relating to psychology, hormones, physiology, and the immune system. The paper concludes with conservative

A Stem Cell Wikipedia

‘...a biopsychosocial model that helps combat patients’

fears and anxieties around their pain...

can help reduce patients’ perception and attitudes about

their pain’

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Heather Gittens, RMT

Contact 778-574-1174 or [email protected]

June 26/16 - Sphenoid Gateway

RMTBCAnvil Centre, New Westminster, BC

April 16 - 18, 2016

M T 2 0 1 6 RMTBC Conference

BANYAN THAI MASSAGEwww.BanyanThaiMassage.com

With Sharon Brown-Horton, teaching affi liate with the famous “ITM School” of Chiang Mai, Thailand

TRADITIONAL THAI MASSAGE LEVEL 1Foundation Skills | 3-days | Vancouver Saturday, Nov. 28 - Monday, Nov. 30, 2015

TRADITIONAL THAI MASSAGE LEVEL 2

Intermediate | 3-days | Vancouver

Friday, Jan. 22 - Sunday, Jan. 24, 2016

Visit us online to see our complete course listings

Contact Instructor for more info: 604.773.2645

All courses occur 9:00 am - 5:00 pm each day


RATES & SPECIFICATIONSIn Circulation

Published by the Registered Massage Therapists’ Association of British Columbia

1x 2x 3x

ISSUE SPACE CLOSE MATERIAL DUE ISSUE DATE

5,000 copies distributed 3 times a year to 3,200 members of the Registered Massage Therapists’ Association of British Columbia. We also provide magazines to other Associations: Newfoundland, P.E.I., Nova Scotia, Ontario, Manitoba, Saskatchewan, Alberta and Northwest Territories.

Continuing Education (CE) Advertising: Lineage 4 columns per page $40 per col. inch | Add 10% for box around ad.Please make sure you include full contact information

• Custom spot colour matched in process • All rates are net and in Canadian dollars • Rates do not include GST

PRINTING PROCESS: Web OffsetSCREEN: 150 lines per inchBINDING METHOD: Saddle-StitchedSUBMISSION GUIDELINES: Please provide PDF file, or an Illustrator CS3 or lower file with all fonts as outlines. Please talk to us first if you’d like to use FTP. BLEED ADS: Please keep all critical elements 1/2” from the trim line

• Advertising non-cancellable after closing date • Production charges are included • Commissions: 15% to recognized agencies

Vol 9 Issue 1 Feb. 8, 2016

Jun. 6, 2016

Oct. 11, 2016

Feb. 15, 2016

Jun. 13, 2016

Oct. 18, 2016

Mar. 2016

Jul. 2016

Nov. 2016

& Free Listings

Vol 9 Issue 2

Vol 9 Issue 3

MEMBERS GET

DISPLAY ADS15% OFF

Full PageType Area2/3 Vertical1/2 Horizontal1/2 Page Island1/2 Page Vertical1/3 Page Horizontal1/3 Page Square1/3 Page Vertical1/4 Page Square1/4 Page HorizontalDouble page spread (bleed)

11 1/69 13/169 7/84 13/167 5/169 13/163 1/84 13/169 7/84 13/162 5/1611 1/16

8 3/87 1/84 11/167 1/84 11/163 1/27 1/84 11/162 1/43 1/27 1/816 1/2

Outside Back Cover(s)Inside Cover(s)Full Page2/3 Page1/2 Page Island1/2 Page Horiz/Vert1/3 Page Square/Horiz/Vert1/4 Page Square/Horiz/Vert

$1,100$985$875$785$655$555$435

$325

$1,040

$930$830$750$620$525$415

$310

$1,195$1,040

$925$830$685$585$465

$340

Ad Rates

NUMBER OF INSERTIONS

SpecificationsRegistered Massage Therapists’ Association of British ColumbiaSuite 180, 1200 West 73rd Avenue, Vancouver, BC V6P 6G5Tel: 604-873-4467 | Toll Free: 1-888-413-4467 | Fax: 604-873-6211

RMTBC DepartmentsSales, Rachelle | ext. 307 |[email protected] Inquires, Kirk / Dereck / Claire | ext. 300 | [email protected] Continuing Ed Assistant, Dereck | ext. 301 | [email protected] Resource Support, Alison | ext. 312 | [email protected] Accounts Manager, Nancy | ext. 302 | [email protected] Coordinator, Dave | ext. 304 | [email protected] of Research, Bodhi | ext. 305 | [email protected], Kristina | ext. 309 | [email protected] Professional Development, Harriet | ext. 303 | [email protected] General Manager, Scantone | ext. 308 | [email protected] Executive Director, Brenda | ext. 306 | [email protected] advertise, email [email protected]

Policy:

31

SIZES WIDTH HEIGHT


Scott Nicoll

[email protected]

YouProtectYourPatients’Health

WE

PROTECT

YOU!

www.panlegal.com

Health Care Law

604.372.4550

You ProtectYour Patients’ Health.

We ProtectYou.

RMT Matters · 2015-12-21 · RMT Registered Massage Therapists’ Association of British Columbia...

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